1. Do you have visible varicose veins (bulging, twisted veins) or spider veins on your legs? *

Yes

No

2. Do your legs feel heavy, tired, or achy, especially after standing or sitting for long periods? *

Yes

No

3. Do you experience swelling in your legs, ankles, or feet (particularly toward the end of the day or after prolonged standing/sitting)? *

Yes

No

4. Do you have leg pain, cramping, aching, or a "restless" feeling in your legs, especially at night? *

Yes

No

5. Have you noticed itching, burning, tingling, or "pins and needles" sensations in your legs? *

Yes

No

6. Has the skin on your lower legs or ankles changed (e.g., become discolored, darker, thicker, drier, or irritated)? *

Yes

No

7. Do your symptoms improve when you elevate your legs (e.g., prop them up above heart level)? *

Yes

No

8. Have you had previous Leg Vein treatments *

Yes

No

If your answer is "YES" for Question #8, Please provide details: How long Ago? Did you see results?

Your Results